Brain imaging research suggests that abnormalities in parts of the brain related to memory and recognition of speech are already present by the time an individual experiences their first episode of psychosis.

Researchers from the Clinical Neuroscience Research Centre (CNRC) and Institute of Psychiatry, in London point out that this implies early detection and even prevention may be possible.

Using magnetic resonance imaging, Alex Sumich and colleagues compared volumes of the hippocampus, amygdala, planum temporale, and Heschl's gyrus in 25 minimally treated patients experiencing their first psychotic episode, and in 16 healthy control subjects.

They found that, compared with the control group, psychotic patients had smaller hippocampal and left planum temporale volumes on the right and the left.

In addition, patients with paranoid psychosis had smaller left amgydala volumes than patients with nonparanoid psychosis.

He adds: 'In time, with a suitable screening method for schizophrenia using brain imaging, preventative psychiatry becomes a realistic possibility.'

Am J Psychiatry 2002; 159: 1232–1234